5.4 The politics of disability
Below you will find links to three support groups. You can select just one of the groups or you may choose to look at all three. Answer the two questions following the links .
Royal National Institute for the Blind
Terrence Higgins Trust : the HIV and AIDS Charity for Life
What concerns do these groups raise about communication and relationships?
How does this connect with the Chapters in Activities 23 and 24?
You probably found in your exploration of support groups online that people using them express some of the concerns explored in the chapters by Lupton and Seymour and by French and Swain, most commonly the need for information, practical help and support, and campaign issues to improve their situation in society.
So far our discussion in this section has been based on an assumption that disabled people are likely to be users of health and social care services. Positioning disabled people as always the receivers of services is part of the way in which disabled people are constructed in society. However, they are also service providers and can be workers in and managers of services. French and Swain claim there is discrimination against disabled people who want to work in health and social care services. The final activity in this course explores this issue further.
Jack is partially sighted and wants to work in the NHS as a nurse. He believes he has excellent communication skills and many of his friends and acquaintances would agree with his view. He has overcome many of the difficulties that are associated with living in the ‘sighted’ world and does not see why he should not succeed in his ambition. A colleague who works in the NHS has advised Jack that he will find it very difficult to be accepted into training and that he should choose a more realistic job.
Activity 27, Doing the job
Read the fictional case study above.
Now make notes in answer to these questions.
Do you think that Jack should apply for the nursing position or would you advise against this?
Give some reasons for your view.
This is an emotive issue. You might have agreed with Jack's friend on the basis that Jack might experience rejection and so perhaps it would be better for him if he was protected from this and not ‘set up to fail’. You might have considered the possible dangers to patients of having a partially sighted nurse caring for them.
My first reaction was it would be very difficult for Jack to do the tasks that require vision. I thought of examples such as reading prescription charts and administering drugs. Using a syringe to give an injection requires nurses to be able to see the markings clearly, so the right amount of drug can be administered. This could make it impossible for Jack to fulfil a key part of the role as a nurse. I also began to ask myself, what about reading monitor screens on a cardiac unit, or noticing a person's skin colour after surgery when there is a need to recognise poor circulation?
I then started to consider whether or not there were ways around these practices that were entirely designed and maintained by sighted people. Although it seemed possible to overcome many of the obstacles I considered, extra resources would need to be in place. In addition there would need to be a commitment to overcoming the barriers that have increased Jack's impairment.
Apart from making sure that Jack is ‘doing the same as everyone else’, there are also questions about the extent to which it is necessary. This challenges the ways nursing is performed and what the job must include.
Finally, the challenges that disabled people make to established ways of doing things can be perceived as threatening by other people.
This activity raised many issues about the nature of disability and the ways in which it is constructed and can serve to exclude people from certain types of work in which their skills might be valuable. This section, like Sections 2 and 3 on ethnicity and gender, aimed to raise questions about the nature of the ‘differences’ that are ascribed to people on the basis of their physical or mental capacities. Taking a mainly social constructionist line, this section tried to show that ‘disability’ is a social process rather than something fixed and essential within individuals. For health and social care services, responding to the communication needs of disabled people involves acknowledging the ways in which structures and processes within organisations can themselves disable and disempower some people, and working to put in place processes that enable and empower people to participate, whether as service users or as workers, on an equal basis.
Whereas a medical model of disability focuses on an individual's disability as a ‘problem’, a social model analyses the ways in which services, and society as a whole, ‘disable’ people through their structures and processes.
Overcoming barriers to effective communication involves addressing these structural factors and aiming for a model of inclusive communication.